Case 36 Mediastinal Lymphadenopathy Due To Lymphoma

See Case 11. The CXR shows asymmetric distortion of the mediastinal contour by markedly enlarged lymph nodes overlying the left hilum. This is described as the hilar overlay sign - the normal left pulmonary artery (Fig. 36.2) is seen through the mass (lying at the anterior mediastinum). Other differential diagnoses include chronic lymphocytic leukemia, sarcoidosis, Castleman's disease, and granulomatous disease like tuberculosis or histoplasmosis. The histology from mediastinoscopy in this patient showed Non Hodgkin's lymphoma.

Hilum Overlay Sign
Fig. 37.1

Case 37. This elderly male was asymptomatic. What is the abnormality on his CXR (Fig. 37.1)? What is the cause?

Mediastinal Lymphadenopathy Cxr
Fig. 37.2

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